Xiao J, Deng S-B, She Q, Li J, Kao G-Y, Wang J-S, Ma Y
Department of Cardiology, Chongqing Medical Emergency Center, Chongqing, China.
Eur Rev Med Pharmacol Sci. 2016;20(4):756-61.
This study sought to observe the effects of allopurinol on the cardiac function of non-hyperuricaemic patients with chronic heart failure and determine the safety of allopurinol for clinical applications.
A group of 125 consecutive cases of non-hyperuricaemic patients with chronic heart failure who were treated at Chongqing Emergency Medical Centre between July 2011 and June 2012 were enrolled and were randomly divided into allopurinol (300 mg/day) group (n=62) and control group (n=63). During the six months treatment period, levels of cardiac function, brachial artery endothelial function, inflammatory cytokines, and biochemical markers were routinely examined.
After three months of allopurinol treatment, patients exhibited an increase in flow-mediated vasodilatation (FMD) of brachial artery, whereas, after six months of treatment, the cardiac function classification was improved; plasma levels of brain natriuretic peptide and tumour necrosis factor-a were decreased; left ventricular internal diameter was diminished; and the ejection fraction was increased (p<0.01 for all the parameters) in patients. Serum uric acid level was decreased during the treatment period for both groups, with no significant difference between the two groups. Liver and kidney dysfunction was not observed among the study participants, and no significant increase in creatine kinase level was detected for either treatment group.
For non-hyperuricaemic patients with chronic heart failure, the addition of six months of allopurinol therapy was safe and effective. Moreover, in these patients, allopurinol treatment not only can significantly ameliorate the left ventricular function and reduce the level of inflammatory factors but could also improve endothelial function.
本研究旨在观察别嘌醇对非高尿酸血症慢性心力衰竭患者心功能的影响，并确定别嘌醇临床应用的安全性。
选取2011年7月至2012年6月在重庆急救医疗中心接受治疗的125例非高尿酸血症慢性心力衰竭连续病例，随机分为别嘌醇组（300mg/天，n = 62）和对照组（n = 63）。在6个月的治疗期间，常规检测心功能、肱动脉内皮功能、炎性细胞因子及生化指标水平。
别嘌醇治疗3个月后，患者肱动脉血流介导的血管舒张功能（FMD）增加；治疗6个月后，心功能分级改善；血浆脑钠肽和肿瘤坏死因子-α水平降低；左心室内径减小；射血分数增加（所有参数p<0.01）。两组治疗期间血清尿酸水平均降低，两组间无显著差异。研究参与者未观察到肝肾功能障碍，两个治疗组的肌酸激酶水平均未显著升高。
对于非高尿酸血症慢性心力衰竭患者，加用6个月的别嘌醇治疗安全有效。此外，在这些患者中，别嘌醇治疗不仅能显著改善左心室功能、降低炎性因子水平，还能改善内皮功能。
